1
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Romani L, Del Chierico F, Pane S, Ristori MV, Pirona I, Guarrasi V, Cotugno N, Bernardi S, Lancella L, Perno CF, Rossi P, Villani A, Campana A, Palma P, Putignani L. Exploring nasopharyngeal microbiota profile in children affected by SARS-CoV-2 infection. Microbiol Spectr 2024; 12:e0300923. [PMID: 38289047 PMCID: PMC10913489 DOI: 10.1128/spectrum.03009-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 12/12/2023] [Indexed: 03/06/2024] Open
Abstract
The relationship between COVID-19 and nasopharyngeal (NP) microbiota has been investigated mainly in the adult population. We explored the NP profile of children affected by COVID-19, compared to healthy controls (CTRLs). NP swabs of children with COVID-19, collected between March and September 2020, were investigated at the admission (T0), 72 h to 7 days (T1), and at the discharge (T2) of the patients. NP microbiota was analyzed by 16S rRNA targeted-metagenomics. Data from sequencing were investigated by QIIME 2.0 and PICRUSt 2. Multiple machine learning (ML) models were exploited to classify patients compared to CTRLs. The NP microbiota of COVID-19 patients (N = 71) was characterized by reduction of α-diversity compared to CTRLs (N = 59). The NP microbiota of COVID-19 cohort appeared significantly enriched in Streptococcus, Haemophilus, Staphylococcus, Veillonella, Enterococcus, Neisseria, Moraxella, Enterobacteriaceae, Gemella, Bacillus, and reduced in Faecalibacterium, Akkermansia, Blautia, Bifidobacterium, Ruminococcus, and Bacteroides, compared to CTRLs (FDR < 0.001). Exploiting ML models, Enterococcus, Pseudomonas, Streptococcus, Capnocytopagha, Tepidiphilus, Porphyromonas, Staphylococcus, and Veillonella resulted as NP microbiota biomarkers, in COVID-19 patients. No statistically significant differences were found comparing the NP microbiota profile of COVID-19 patients during the time-points or grouping patients on the basis of high, medium, and low viral load (VL). This evidence provides specific pathobiont signatures of the NP microbiota in pediatric COVID-19 patients, and the reduction of anaerobic protective commensals. Our data suggest that the NP microbiota may have a specific disease-related signature since infection onset without changes during disease progression, regardless of the SARS-CoV-2 VL. IMPORTANCE Since the beginning of pandemic, we know that children are less susceptible to severe COVID-19 disease. A potential role of the nasopharyngeal (NP) microbiota has been hypothesized but to date, most of the studies have been focused on adults. We studied the NP microbiota modifications in children affected by SARS-CoV-2 infection showing a specific NP microbiome profile, mainly composed by pathobionts and almost missing protective anaerobic commensals. Moreover, in our study, specific microbial signatures appear since the first days of infection independently from SARS-CoV-2 viral load.
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Affiliation(s)
- L. Romani
- Infectious Disease Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - F. Del Chierico
- Research Unit of Human Microbiome, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - S. Pane
- Unit of Microbiomics, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - M. V. Ristori
- Research Unit of Human Microbiome, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - I. Pirona
- GenomeUp SRL, Viale Pasteur, Rome, Italy
| | | | - N. Cotugno
- Research Unit of Congenital and Perinatal Infections, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Department of Systems Medicine, University of Rome ‘‘Tor Vergata’’, Rome, Italy
| | - S. Bernardi
- Infectious Disease Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - L. Lancella
- Infectious Disease Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - C. F. Perno
- Unit of Microbiology and Diagnostic Immunology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - P. Rossi
- Department of Systems Medicine, University of Rome ‘‘Tor Vergata’’, Rome, Italy
- Academic Department of Pediatrics, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - A. Villani
- Pediatric Emergency Department and General Pediatrics, Bambino Gesù Children's Hospital Bambino Gesù, IRCCS, Rome, Italy
| | - A. Campana
- Department of Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - P. Palma
- Research Unit of Congenital and Perinatal Infections, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Department of Systems Medicine, University of Rome ‘‘Tor Vergata’’, Rome, Italy
| | - L. Putignani
- Unit of Microbiomics and Research Unit of Human Microbiome, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - the CACTUS Study TeamCarducciFrancesca CalòCancriniCaterinaChiurchiùSaradegli AttiMarta CiofiCursiLauraCutreraRenatoD’AmoreCarmenD’ArgenioPatriziaDe IorisMaria A.De LucaMaiaFinocchiAndreaMannoEmma ConcettaMorrocchiElenaPansaPaolaSessaLiberaZangariPaola
- Infectious Disease Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Research Unit of Human Microbiome, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
- Unit of Microbiomics, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- GenomeUp SRL, Viale Pasteur, Rome, Italy
- Research Unit of Congenital and Perinatal Infections, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Department of Systems Medicine, University of Rome ‘‘Tor Vergata’’, Rome, Italy
- Unit of Microbiology and Diagnostic Immunology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
- Academic Department of Pediatrics, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Pediatric Emergency Department and General Pediatrics, Bambino Gesù Children's Hospital Bambino Gesù, IRCCS, Rome, Italy
- Department of Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
- Unit of Microbiomics and Research Unit of Human Microbiome, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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2
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Vernocchi P, Marangelo C, Guerrera S, Del Chierico F, Guarrasi V, Gardini S, Conte F, Paci P, Ianiro G, Gasbarrini A, Vicari S, Putignani L. Gut microbiota functional profiling in autism spectrum disorders: bacterial VOCs and related metabolic pathways acting as disease biomarkers and predictors. Front Microbiol 2023; 14:1287350. [PMID: 38192296 PMCID: PMC10773764 DOI: 10.3389/fmicb.2023.1287350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/14/2023] [Indexed: 01/10/2024] Open
Abstract
Background Autism spectrum disorder (ASD) is a multifactorial neurodevelopmental disorder. Major interplays between the gastrointestinal (GI) tract and the central nervous system (CNS) seem to be driven by gut microbiota (GM). Herein, we provide a GM functional characterization, based on GM metabolomics, mapping of bacterial biochemical pathways, and anamnestic, clinical, and nutritional patient metadata. Methods Fecal samples collected from children with ASD and neurotypical children were analyzed by gas-chromatography mass spectrometry coupled with solid phase microextraction (GC-MS/SPME) to determine volatile organic compounds (VOCs) associated with the metataxonomic approach by 16S rRNA gene sequencing. Multivariate and univariate statistical analyses assessed differential VOC profiles and relationships with ASD anamnestic and clinical features for biomarker discovery. Multiple web-based and machine learning (ML) models identified metabolic predictors of disease and network analyses correlated GM ecological and metabolic patterns. Results The GM core volatilome for all ASD patients was characterized by a high concentration of 1-pentanol, 1-butanol, phenyl ethyl alcohol; benzeneacetaldehyde, octadecanal, tetradecanal; methyl isobutyl ketone, 2-hexanone, acetone; acetic, propanoic, 3-methyl-butanoic and 2-methyl-propanoic acids; indole and skatole; and o-cymene. Patients were stratified based on age, GI symptoms, and ASD severity symptoms. Disease risk prediction allowed us to associate butanoic acid with subjects older than 5 years, indole with the absence of GI symptoms and low disease severity, propanoic acid with the ASD risk group, and p-cymene with ASD symptoms, all based on the predictive CBCL-EXT scale. The HistGradientBoostingClassifier model classified ASD patients vs. CTRLs by an accuracy of 89%, based on methyl isobutyl ketone, benzeneacetaldehyde, phenyl ethyl alcohol, ethanol, butanoic acid, octadecane, acetic acid, skatole, and tetradecanal features. LogisticRegression models corroborated methyl isobutyl ketone, benzeneacetaldehyde, phenyl ethyl alcohol, skatole, and acetic acid as ASD predictors. Conclusion Our results will aid the development of advanced clinical decision support systems (CDSSs), assisted by ML models, for advanced ASD-personalized medicine, based on omics data integrated into electronic health/medical records. Furthermore, new ASD screening strategies based on GM-related predictors could be used to improve ASD risk assessment by uncovering novel ASD onset and risk predictors.
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Affiliation(s)
- Pamela Vernocchi
- Research Unit of Human Microbiome, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Chiara Marangelo
- Research Unit of Human Microbiome, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Silvia Guerrera
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Federica Del Chierico
- Research Unit of Human Microbiome, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | | | | | - Federica Conte
- Institute for Systems Analysis and Computer Science “Antonio Ruberti”, National Research Council, Rome, Italy
| | - Paola Paci
- Department of Computer, Control and Management Engineering, Sapienza University of Rome, Rome, Italy
| | - Gianluca Ianiro
- CEMAD Digestive Disease Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Antonio Gasbarrini
- CEMAD Digestive Disease Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Stefano Vicari
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
- Life Sciences and Public Health Department, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Lorenza Putignani
- Unit of Microbiomics and Research Unit of Human Microbiome, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
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3
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Marzano V, Levi Mortera S, Vernocchi P, Del Chierico F, Marangelo C, Guarrasi V, Gardini S, Dentici ML, Capolino R, Digilio MC, Di Donato M, Spasari I, Abreu MT, Dallapiccola B, Putignani L. Williams-Beuren syndrome shapes the gut microbiota metaproteome. Sci Rep 2023; 13:18963. [PMID: 37923896 PMCID: PMC10624682 DOI: 10.1038/s41598-023-46052-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/27/2023] [Indexed: 11/06/2023] Open
Abstract
Williams-Beuren syndrome (WBS) is a rare genetic neurodevelopmental disorder with multi-systemic manifestations. The evidence that most subjects with WBS face gastrointestinal (GI) comorbidities, have prompted us to carry out a metaproteomic investigation of their gut microbiota (GM) profile compared to age-matched healthy subjects (CTRLs). Metaproteomic analysis was carried out on fecal samples collected from 41 individuals with WBS, and compared with samples from 45 CTRLs. Stool were extracted for high yield in bacterial protein group (PG) content, trypsin-digested and analysed by nanoLiquid Chromatography-Mass Spectrometry. Label free quantification, taxonomic assignment by the lowest common ancestor (LCA) algorithm and functional annotations by COG and KEGG databases were performed. Data were statistically interpreted by multivariate and univariate analyses. A WBS GM functional dissimilarity respect to CTRLs, regardless age distribution, was reported. The alterations in function of WBSs GM was primarily based on bacterial pathways linked to carbohydrate transport and metabolism and energy production. Influence of diet, obesity, and GI symptoms was assessed, highlighting changes in GM biochemical patterns, according to WBS subsets' stratification. The LCA-derived ecology unveiled WBS-related functionally active bacterial signatures: Bacteroidetes related to over-expressed PGs, and Firmicutes, specifically the specie Faecalibacterium prausnitzii, linked to under-expressed PGs, suggesting a depletion of beneficial bacteria. These new evidences on WBS gut dysbiosis may offer novel targets for tailored interventions.
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Affiliation(s)
- Valeria Marzano
- Research Unit of Human Microbiome, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Stefano Levi Mortera
- Research Unit of Human Microbiome, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Pamela Vernocchi
- Research Unit of Human Microbiome, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Federica Del Chierico
- Research Unit of Human Microbiome, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Chiara Marangelo
- Research Unit of Human Microbiome, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Valerio Guarrasi
- GenomeUp s.r.l., Rome, Italy
- Unit of Computer Systems and Bioinformatics, Department of Engineering, University Campus Bio-Medico of Rome, Rome, Italy
| | | | - Maria Lisa Dentici
- Genetics and Rare Diseases Research Division, Medical Genetics Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Rossella Capolino
- Genetics and Rare Diseases Research Division, Medical Genetics Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Maria Cristina Digilio
- Genetics and Rare Diseases Research Division, Medical Genetics Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Maddalena Di Donato
- Translational Cytogenomics Research Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Iolanda Spasari
- Translational Cytogenomics Research Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Maria Teresa Abreu
- Division of Digestive Health and Liver Diseases, Department of Medicine, Crohn's and Colitis Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Bruno Dallapiccola
- Scientific Directorate, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Lorenza Putignani
- Unit of Microbiomics and Research Unit of Human Microbiome, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
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4
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Laterza L, Putignani L, Settanni CR, Petito V, Varca S, De Maio F, Macari G, Guarrasi V, Gremese E, Tolusso B, Wlderk G, Pirro MA, Fanali C, Scaldaferri F, Turchini L, Amatucci V, Sanguinetti M, Gasbarrini A. Ecology and Machine Learning-Based Classification Models of Gut Microbiota and Inflammatory Markers May Evaluate the Effects of Probiotic Supplementation in Patients Recently Recovered from COVID-19. Int J Mol Sci 2023; 24:ijms24076623. [PMID: 37047594 PMCID: PMC10094838 DOI: 10.3390/ijms24076623] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/24/2023] [Accepted: 03/28/2023] [Indexed: 04/05/2023] Open
Abstract
Gut microbiota (GM) modulation can be investigated as possible solution to enhance recovery after COVID-19. An open-label, single-center, single-arm, pilot, interventional study was performed by enrolling twenty patients recently recovered from COVID-19 to investigate the role of a mixed probiotic, containing Lactobacilli, Bifidobacteria and Streptococcus thermophilus, on gastrointestinal symptoms, local and systemic inflammation, intestinal barrier integrity and GM profile. Gastrointestinal Symptom Rating Scale, cytokines, inflammatory, gut permeability, and integrity markers were evaluated before (T0) and after 8 weeks (T1) of probiotic supplementation. GM profiling was based on 16S-rRNA targeted-metagenomics and QIIME 2.0, LEfSe and PICRUSt computational algorithms. Multiple machine learning (ML) models were trained to classify GM at T0 and T1. A statistically significant reduction of IL-6 (p < 0.001), TNF-α (p < 0.001) and IL-12RA (p < 0.02), citrulline (p value < 0.001) was reported at T1. GM global distribution and microbial biomarkers strictly reflected probiotic composition, with a general increase in Bifidobacteria at T1. Twelve unique KEGG orthologs were associated only to T0, including tetracycline resistance cassettes. ML classified the GM at T1 with 100% score at phylum level. Bifidobacteriaceae and Bifidobacterium spp. inversely correlated to reduction of citrulline and inflammatory cytokines. Probiotic supplementation during post-COVID-19 may trigger anti-inflammatory effects though Bifidobacteria and related-metabolism enhancement.
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Affiliation(s)
- Lucrezia Laterza
- CeMAD, Digestive Disease Center, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy
| | - Lorenza Putignani
- Department of Diagnostics and Laboratory Medicine, Unit of Microbiology and Diagnostic Immunology, Unit of Microbiomics and Immunology, Rheumatology and Infectious diseases Research Area, Unit of Human Microbiome, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | - Carlo Romano Settanni
- CeMAD, Digestive Disease Center, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy
| | - Valentina Petito
- CeMAD, Digestive Disease Center, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy
| | - Simone Varca
- CeMAD, Digestive Disease Center, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy
| | - Flavio De Maio
- Laboratorio di Microbiologia Clinica, Dipartimento di Scienze di Laboratorio ed Infettivologiche, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy
| | | | | | - Elisa Gremese
- Immunology Facility, Gstep, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy
| | - Barbara Tolusso
- Immunology Facility, Gstep, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy
| | - Giulia Wlderk
- CeMAD, Digestive Disease Center, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy
| | - Maria Antonia Pirro
- CeMAD, Digestive Disease Center, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy
| | - Caterina Fanali
- CeMAD, Digestive Disease Center, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy
| | - Franco Scaldaferri
- CeMAD, Digestive Disease Center, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy
| | - Laura Turchini
- CeMAD, Digestive Disease Center, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy
| | - Valeria Amatucci
- CeMAD, Digestive Disease Center, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy
| | - Maurizio Sanguinetti
- Laboratorio di Microbiologia Clinica, Dipartimento di Scienze di Laboratorio ed Infettivologiche, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy
| | - Antonio Gasbarrini
- CeMAD, Digestive Disease Center, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy
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5
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Guarrasi V, Soda P. Multi-objective optimization determines when, which and how to fuse deep networks: An application to predict COVID-19 outcomes. Comput Biol Med 2023; 154:106625. [PMID: 36738713 PMCID: PMC9892294 DOI: 10.1016/j.compbiomed.2023.106625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 01/18/2023] [Accepted: 01/28/2023] [Indexed: 02/05/2023]
Abstract
The COVID-19 pandemic has caused millions of cases and deaths and the AI-related scientific community, after being involved with detecting COVID-19 signs in medical images, has been now directing the efforts towards the development of methods that can predict the progression of the disease. This task is multimodal by its very nature and, recently, baseline results achieved on the publicly available AIforCOVID dataset have shown that chest X-ray scans and clinical information are useful to identify patients at risk of severe outcomes. While deep learning has shown superior performance in several medical fields, in most of the cases it considers unimodal data only. In this respect, when, which and how to fuse the different modalities is an open challenge in multimodal deep learning. To cope with these three questions here we present a novel approach optimizing the setup of a multimodal end-to-end model. It exploits Pareto multi-objective optimization working with a performance metric and the diversity score of multiple candidate unimodal neural networks to be fused. We test our method on the AIforCOVID dataset, attaining state-of-the-art results, not only outperforming the baseline performance but also being robust to external validation. Moreover, exploiting XAI algorithms we figure out a hierarchy among the modalities and we extract the features' intra-modality importance, enriching the trust on the predictions made by the model.
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Affiliation(s)
- Valerio Guarrasi
- Unit of Computer Systems and Bioinformatics, Department of Engineering, University Campus Bio-Medico of Rome, Italy; Department of Computer, Control, and Management Engineering, Sapienza University of Rome, Italy.
| | - Paolo Soda
- Unit of Computer Systems and Bioinformatics, Department of Engineering, University Campus Bio-Medico of Rome, Italy; Department of Radiation Sciences, Radiation Physics, Biomedical Engineering, Umeå, University, Umeå, Sweden.
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6
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Infantino M, Palterer B, Previtali G, Alessio M, Villalta D, Carbone T, Platzgummer S, Paura G, Castiglione C, Fabris M, Pesce G, Porcelli B, Terzuoli L, Bacarelli M, Tampoia M, Cinquanta L, Brusca I, Buzzolini F, Benucci M, Tortora M, Tronchin L, Guarrasi V, Soda P, Manfredi M, Bizzaro N. Comparison of current methods for
anti‐dsDNA
antibody detection and reshaping diagnostic strategies. Scand J Immunol 2022; 96:e13220. [DOI: 10.1111/sji.13220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 09/03/2022] [Accepted: 09/26/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Maria Infantino
- Laboratorio di Immunologia e Allergologia, Ospedale S. Giovanni di Dio Firenze Italy
| | - Boaz Palterer
- Università degli studi di Firenze, Dipartimento di Medicina Sperimentale e Clinica Firenze Italy
| | - Giulia Previtali
- Laboratorio Analisi Chimico Cliniche, ASST Papa Giovanni XXIII Bergamo Italy
| | | | - Danilo Villalta
- SSD di Allergologia e Immunologia clinica, Presidio Ospedaliero S. Maria degli Angeli Pordenone Italy
| | - Teresa Carbone
- UOC Patologia Clinica Microbiologia e Medicina di Laboratorio, Azienda Sanitaria Locale di Matera (ASM), Matera Italy
| | | | - Giusi Paura
- Laboratorio Analisi, Ospedale Civile, Voghera Italy
| | | | - Martina Fabris
- SOC Istituto di Patologia Clinica, Azienda Sanitaria Universitaria Integrata Udine Italy
| | - Giampaola Pesce
- Laboratorio Diagnostico di Autoimmunologia, IRCCS Ospedale Policlinico San Martino Genova
- Dipartimento di Medicina Interna e Specialità Mediche (DIMI), Università di Genova Genova Italy
| | - Brunetta Porcelli
- UOC Laboratorio Patologia Clinica, Policlinico S. Maria alle Scotte, AOU Senese Siena Italy
- Dipartimento Biotecnologie Mediche, Università degli Studi di Siena Siena
| | - Lucia Terzuoli
- UOC Laboratorio Patologia Clinica, Policlinico S. Maria alle Scotte, AOU Senese Siena Italy
- Dipartimento Biotecnologie Mediche, Università degli Studi di Siena Siena
| | - Maria‐Romana Bacarelli
- UOC Laboratorio Patologia Clinica, Policlinico S. Maria alle Scotte, AOU Senese Siena Italy
- Dipartimento Scienze Mediche Chirurgiche e Neuroscienze, Università degli Studi di Siena Siena Italy
| | - Marilina Tampoia
- Patologia Clinica, Microbiologia e Genetica Medica, ASL TA Taranto Italy
| | - Luigi Cinquanta
- IRCCS S.D.N., Napoli, Italy; 17Patologia Clinica, Ospedale Buccheri La Ferla FBF Palermo Italy
| | | | - Francesca Buzzolini
- SSD di Allergologia e Immunologia clinica, Presidio Ospedaliero S. Maria degli Angeli Pordenone Italy
| | | | - Matteo Tortora
- Unità di Sistemi di elaborazione e bioinformatica, Facoltà dipartimentale di Ingegneria, Università Campus Bio‐Medico Rome Italy
| | - Lorenzo Tronchin
- Unità di Sistemi di elaborazione e bioinformatica, Facoltà dipartimentale di Ingegneria, Università Campus Bio‐Medico Rome Italy
| | - Valerio Guarrasi
- Unità di Sistemi di elaborazione e bioinformatica, Facoltà dipartimentale di Ingegneria, Università Campus Bio‐Medico Rome Italy
- Dipartimento di Ingegneria Informatica Automatica e Gestionale, Sapienza Università di Roma Rome Italy
| | - Paolo Soda
- Unità di Sistemi di elaborazione e bioinformatica, Facoltà dipartimentale di Ingegneria, Università Campus Bio‐Medico Rome Italy
| | - Mariangela Manfredi
- Laboratorio di Immunologia e Allergologia, Ospedale S. Giovanni di Dio Firenze Italy
| | - Nicola Bizzaro
- Laboratorio di Patologia Clinica, Ospedale San Antonio, Azienda Sanitaria Universitaria Integrata Udine Italy
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7
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Romani L, Del Chierico F, Macari G, Pane S, Ristori MV, Guarrasi V, Gardini S, Pascucci GR, Cotugno N, Perno CF, Rossi P, Villani A, Bernardi S, Campana A, Palma P, Putignani L. The Relationship Between Pediatric Gut Microbiota and SARS-CoV-2 Infection. Front Cell Infect Microbiol 2022; 12:908492. [PMID: 35873161 PMCID: PMC9304937 DOI: 10.3389/fcimb.2022.908492] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 06/14/2022] [Indexed: 12/12/2022] Open
Abstract
This is the first study on gut microbiota (GM) in children affected by coronavirus disease 2019 (COVID-19). Stool samples from 88 patients with suspected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and 95 healthy subjects were collected (admission: 3–7 days, discharge) to study GM profile by 16S rRNA gene sequencing and relationship to disease severity. The study group was divided in COVID-19 (68), Non–COVID-19 (16), and MIS-C (multisystem inflammatory syndrome in children) (4). Correlations among GM ecology, predicted functions, multiple machine learning (ML) models, and inflammatory response were provided for COVID-19 and Non–COVID-19 cohorts. The GM of COVID-19 cohort resulted as dysbiotic, with the lowest α-diversity compared with Non–COVID-19 and CTRLs and by a specific β-diversity. Its profile appeared enriched in Faecalibacterium, Fusobacterium, and Neisseria and reduced in Bifidobacterium, Blautia, Ruminococcus, Collinsella, Coprococcus, Eggerthella, and Akkermansia, compared with CTRLs (p < 0.05). All GM paired-comparisons disclosed comparable results through all time points. The comparison between COVID-19 and Non–COVID-19 cohorts highlighted a reduction of Abiotrophia in the COVID-19 cohort (p < 0.05). The GM of MIS-C cohort was characterized by an increase of Veillonella, Clostridium, Dialister, Ruminococcus, and Streptococcus and a decrease of Bifidobacterium, Blautia, Granulicatella, and Prevotella, compared with CTRLs. Stratifying for disease severity, the GM associated to “moderate” COVID-19 was characterized by lower α-diversity compared with “mild” and “asymptomatic” and by a GM profile deprived in Neisseria, Lachnospira, Streptococcus, and Prevotella and enriched in Dialister, Acidaminococcus, Oscillospora, Ruminococcus, Clostridium, Alistipes, and Bacteroides. The ML models identified Staphylococcus, Anaerostipes, Faecalibacterium, Dorea, Dialister, Streptococcus, Roseburia, Haemophilus, Granulicatella, Gemmiger, Lachnospira, Corynebacterium, Prevotella, Bilophila, Phascolarctobacterium, Oscillospira, and Veillonella as microbial markers of COVID-19. The KEGG ortholog (KO)–based prediction of GM functional profile highlighted 28 and 39 KO-associated pathways to COVID-19 and CTRLs, respectively. Finally, Bacteroides and Sutterella correlated with proinflammatory cytokines regardless disease severity. Unlike adult GM profiles, Faecalibacterium was a specific marker of pediatric COVID-19 GM. The durable modification of patients’ GM profile suggested a prompt GM quenching response to SARS-CoV-2 infection since the first symptoms. Faecalibacterium and reduced fatty acid and amino acid degradation were proposed as specific COVID-19 disease traits, possibly associated to restrained severity of SARS-CoV-2–infected children. Altogether, this evidence provides a characterization of the pediatric COVID-19–related GM.
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Affiliation(s)
- Lorenza Romani
- Infectious Disease Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Federica Del Chierico
- Multimodal Laboratory Medicine Research Area, Unit of Human Microbiome, IRCCS, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | | | - Stefania Pane
- Department of Diagnostic and Laboratory Medicine, Unit of Microbiology and Diagnostic Immunology, Unit of Microbiomics, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Maria Vittoria Ristori
- Multimodal Laboratory Medicine Research Area, Unit of Human Microbiome, IRCCS, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | | | | | - Giuseppe Rubens Pascucci
- Research Unit of Congenital and Perinatal Infections, Bambino Gesu` Children’s Hospital, IRCCS, Rome, Italy
| | - Nicola Cotugno
- Research Unit of Congenital and Perinatal Infections, Bambino Gesu` Children’s Hospital, IRCCS, Rome, Italy
- Chair of Pediatrics, Department of Systems Medicine, University of Rome ‘‘Tor Vergata’’, Rome, Italy
| | - Carlo Federico Perno
- Department of Diagnostic and Laboratory Medicine, Unit of Microbiology and Diagnostic Immunology, Multimodal Laboratory Medicine Research Area, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Paolo Rossi
- Chair of Pediatrics, Department of Systems Medicine, University of Rome ‘‘Tor Vergata’’, Rome, Italy
- Academic Department of Pediatrics, Bambino Gesu` Children’s Hospital, IRCCS, Rome, Italy
| | - Alberto Villani
- Pediatric Emergency Department and General Pediatrics, Children Hospital Bambino Gesù, IRCCS, Rome, Italy
| | - Stefania Bernardi
- Infectious Disease Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Andrea Campana
- Department of Pediatrics, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Paolo Palma
- Research Unit of Congenital and Perinatal Infections, Bambino Gesu` Children’s Hospital, IRCCS, Rome, Italy
- Chair of Pediatrics, Department of Systems Medicine, University of Rome ‘‘Tor Vergata’’, Rome, Italy
| | - Lorenza Putignani
- Department of Diagnostic and Laboratory Medicine, Unit of Microbiology and Diagnostic Immunology, Unit of Microbiomics and Multimodal Laboratory Medicine Research Area, Unit of Human Microbiome, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- *Correspondence: Lorenza Putignani,
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Vernocchi P, Ristori MV, Guerrera S, Guarrasi V, Conte F, Russo A, Lupi E, Albitar-Nehme S, Gardini S, Paci P, Ianiro G, Vicari S, Gasbarrini A, Putignani L. Gut Microbiota Ecology and Inferred Functions in Children With ASD Compared to Neurotypical Subjects. Front Microbiol 2022; 13:871086. [PMID: 35756062 PMCID: PMC9218677 DOI: 10.3389/fmicb.2022.871086] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/19/2022] [Indexed: 12/28/2022] Open
Abstract
Autism spectrum disorders (ASDs) is a multifactorial neurodevelopmental disorder. The communication between the gastrointestinal (GI) tract and the central nervous system seems driven by gut microbiota (GM). Herein, we provide GM profiling, considering GI functional symptoms, neurological impairment, and dietary habits. Forty-one and 35 fecal samples collected from ASD and neurotypical children (CTRLs), respectively, (age range, 3–15 years) were analyzed by 16S targeted-metagenomics (the V3–V4 region) and inflammation and permeability markers (i.e., sIgA, zonulin lysozyme), and then correlated with subjects’ metadata. Our ASD cohort was characterized as follows: 30/41 (73%) with GI functional symptoms; 24/41 (58%) picky eaters (PEs), with one or more dietary needs, including 10/41 (24%) with food selectivity (FS); 36/41 (88%) presenting high and medium autism severity symptoms (HMASSs). Among the cohort with GI symptoms, 28/30 (93%) showed HMASSs, 17/30 (57%) were picky eaters and only 8/30 (27%) with food selectivity. The remaining 11/41 (27%) ASDs without GI symptoms that were characterized by HMASS for 8/11 (72%) and 7/11 (63%) were picky eaters. GM ecology was investigated for the overall ASD cohort versus CTRLs; ASDs with GI and without GI, respectively, versus CTRLs; ASD with GI versus ASD without GI; ASDs with HMASS versus low ASSs; PEs versus no-PEs; and FS versus absence of FS. In particular, the GM of ASDs, compared to CTRLs, was characterized by the increase of Proteobacteria, Bacteroidetes, Rikenellaceae, Pasteurellaceae, Klebsiella, Bacteroides, Roseburia, Lactobacillus, Prevotella, Sutterella, Staphylococcus, and Haemophilus. Moreover, Sutterella, Roseburia and Fusobacterium were associated to ASD with GI symptoms compared to CTRLs. Interestingly, ASD with GI symptoms showed higher value of zonulin and lower levels of lysozyme, which were also characterized by differentially expressed predicted functional pathways. Multiple machine learning models classified correctly 80% overall ASDs, compared with CTRLs, based on Bacteroides, Lactobacillus, Prevotella, Staphylococcus, Sutterella, and Haemophilus features. In conclusion, in our patient cohort, regardless of the evaluation of many factors potentially modulating the GM profile, the major phenotypic determinant affecting the GM was represented by GI hallmarks and patients’ age.
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Affiliation(s)
- Pamela Vernocchi
- Multimodal Laboratory Medicine Research Area, Unit of Human Microbiome, Bambino Gesù Children's Hospital, Scientific Institute for Research, Hospitalization and Healthcare, Rome, Italy
| | - Maria Vittoria Ristori
- Multimodal Laboratory Medicine Research Area, Unit of Human Microbiome, Bambino Gesù Children's Hospital, Scientific Institute for Research, Hospitalization and Healthcare, Rome, Italy
| | - Silvia Guerrera
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Scientific Institute for Research, Hospitalization and Healthcare, Rome, Italy
| | | | - Federica Conte
- Institute for Systems Analysis and Computer Science "Antonio Ruberti," National Research Council, Rome, Italy
| | - Alessandra Russo
- Department of Diagnostics and Laboratory Medicine, Unit of Microbiology and Diagnostic Immunology, Unit of Microbiomics, Bambino Gesù Children's Hospital, Scientific Institute for Research, Hospitalization and Healthcare, Rome, Italy
| | - Elisabetta Lupi
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Scientific Institute for Research, Hospitalization and Healthcare, Rome, Italy
| | - Sami Albitar-Nehme
- Department of Diagnostic and Laboratory Medicine, Unit of Microbiology and Diagnostic Immunology, Bambino Gesù Children's Hospital, Scientific Institute for Research, Hospitalization and Healthcare, Rome, Italy
| | | | - Paola Paci
- Department of Computer, Control and Management Engineering, Sapienza University of Rome, Rome, Italy
| | - Gianluca Ianiro
- CEMAD Digestive Disease Center, Fondazione Policlinico Universitario "A. Gemelli" Scientific Institute for Research, Hospitalization and Healthcare, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Stefano Vicari
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Scientific Institute for Research, Hospitalization and Healthcare, Rome, Italy
| | - Antonio Gasbarrini
- CEMAD Digestive Disease Center, Fondazione Policlinico Universitario "A. Gemelli" Scientific Institute for Research, Hospitalization and Healthcare, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Lorenza Putignani
- Department of Diagnostics and Laboratory Medicine, Unit of Microbiology and Diagnostic Immunology, Unit of Microbiomics, and Multimodal Laboratory Medicine Research Area, Unit of Human Microbiome, Bambino Gesù Children's Hospital, Scientific Institute for Research, Hospitalization and Healthcare, Rome, Italy
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Guarrasi V, D'Amico NC, Sicilia R, Cordelli E, Soda P. Pareto optimization of deep networks for COVID-19 diagnosis from chest X-rays. Pattern Recognit 2022; 121:108242. [PMID: 34393277 PMCID: PMC8351284 DOI: 10.1016/j.patcog.2021.108242] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 07/26/2021] [Accepted: 08/08/2021] [Indexed: 05/05/2023]
Abstract
The year 2020 was characterized by the COVID-19 pandemic that has caused, by the end of March 2021, more than 2.5 million deaths worldwide. Since the beginning, besides the laboratory test, used as the gold standard, many applications have been applying deep learning algorithms to chest X-ray images to recognize COVID-19 infected patients. In this context, we found out that convolutional neural networks perform well on a single dataset but struggle to generalize to other data sources. To overcome this limitation, we propose a late fusion approach where we combine the outputs of several state-of-the-art CNNs, introducing a novel method that allows us to construct an optimum ensemble determining which and how many base learners should be aggregated. This choice is driven by a two-objective function that maximizes, on a validation set, the accuracy and the diversity of the ensemble itself. A wide set of experiments on several publicly available datasets, accounting for more than 92,000 images, shows that the proposed approach provides average recognition rates up to 93.54% when tested on external datasets.
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Affiliation(s)
- Valerio Guarrasi
- Unit of Computer Systems and Bioinformatics, Department of Engineering, University Campus Bio-Medico of Rome, Italy
- Department of Computer, Control, and Management Engineering, Sapienza University of Rome, Italy
| | - Natascha Claudia D'Amico
- Department of Diagnostic Imaging and Stereotactic Radiosurgery, Centro Diagnostico Italiano S.p.A., Milan, Italy
- Unit of Computer Systems and Bioinformatics, Department of Engineering, University Campus Bio-Medico of Rome, Italy
| | - Rosa Sicilia
- Unit of Computer Systems and Bioinformatics, Department of Engineering, University Campus Bio-Medico of Rome, Italy
| | - Ermanno Cordelli
- Unit of Computer Systems and Bioinformatics, Department of Engineering, University Campus Bio-Medico of Rome, Italy
| | - Paolo Soda
- Unit of Computer Systems and Bioinformatics, Department of Engineering, University Campus Bio-Medico of Rome, Italy
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Soda P, D'Amico NC, Tessadori J, Valbusa G, Guarrasi V, Bortolotto C, Akbar MU, Sicilia R, Cordelli E, Fazzini D, Cellina M, Oliva G, Callea G, Panella S, Cariati M, Cozzi D, Miele V, Stellato E, Carrafiello G, Castorani G, Simeone A, Preda L, Iannello G, Del Bue A, Tedoldi F, Alí M, Sona D, Papa S. AIforCOVID: Predicting the clinical outcomes in patients with COVID-19 applying AI to chest-X-rays. An Italian multicentre study. Med Image Anal 2021; 74:102216. [PMID: 34492574 PMCID: PMC8401374 DOI: 10.1016/j.media.2021.102216] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 08/03/2021] [Accepted: 08/18/2021] [Indexed: 01/08/2023]
Abstract
Recent epidemiological data report that worldwide more than 53 million people have been infected by SARS-CoV-2, resulting in 1.3 million deaths. The disease has been spreading very rapidly and few months after the identification of the first infected, shortage of hospital resources quickly became a problem. In this work we investigate whether artificial intelligence working with chest X-ray (CXR) scans and clinical data can be used as a possible tool for the early identification of patients at risk of severe outcome, like intensive care or death. Indeed, further to induce lower radiation dose than computed tomography (CT), CXR is a simpler and faster radiological technique, being also more widespread. In this respect, we present three approaches that use features extracted from CXR images, either handcrafted or automatically learnt by convolutional neuronal networks, which are then integrated with the clinical data. As a further contribution, this work introduces a repository that collects data from 820 patients enrolled in six Italian hospitals in spring 2020 during the first COVID-19 emergency. The dataset includes CXR images, several clinical attributes and clinical outcomes. Exhaustive evaluation shows promising performance both in 10-fold and leave-one-centre-out cross-validation, suggesting that clinical data and images have the potential to provide useful information for the management of patients and hospital resources.
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Affiliation(s)
- Paolo Soda
- Unit of Computer Systems and Bioinformatics, Department of Engineering, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 21, Rome 00128, Italy.
| | - Natascha Claudia D'Amico
- Unit of Computer Systems and Bioinformatics, Department of Engineering, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 21, Rome 00128, Italy; Department of Diagnostic Imaging and Stereotactic Radiosurgey, Centro Diagnostico Italiano S.p.A., Via S. Saint Bon 20, Milan 20147, Italy
| | - Jacopo Tessadori
- Pattern Analysis and Computer Vision, Istituto Italiano di Tecnologia, Via Morego 30, Genoa 16163, Italy
| | - Giovanni Valbusa
- Bracco Imaging S.p.A., Via Caduti di Marcinelle 13, Milan 20134, Italy
| | - Valerio Guarrasi
- Unit of Computer Systems and Bioinformatics, Department of Engineering, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 21, Rome 00128, Italy; Department of Computer, Control, and Management Engineering, Sapienza University of Rome, Via Ariosto, 25, Rome 00185, Italy
| | - Chandra Bortolotto
- Radiology Institute, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, Pavia 27100, Italy
| | - Muhammad Usman Akbar
- Pattern Analysis and Computer Vision, Istituto Italiano di Tecnologia, Via Morego 30, Genoa 16163, Italy; Department of Naval, Electrical, Electronic and Telecommunications Engineering University of Genova, Via All'Opera Pia 11 A, Genoa 16145, Italy
| | - Rosa Sicilia
- Unit of Computer Systems and Bioinformatics, Department of Engineering, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 21, Rome 00128, Italy
| | - Ermanno Cordelli
- Unit of Computer Systems and Bioinformatics, Department of Engineering, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 21, Rome 00128, Italy
| | - Deborah Fazzini
- Department of Diagnostic Imaging and Stereotactic Radiosurgey, Centro Diagnostico Italiano S.p.A., Via S. Saint Bon 20, Milan 20147, Italy
| | - Michaela Cellina
- Radiology Department, ASST Fatebenefratelli Sacco, Piazza Principessa Clotilde 3, Milan 20121, Italy
| | - Giancarlo Oliva
- Radiology Department, ASST Fatebenefratelli Sacco, Piazza Principessa Clotilde 3, Milan 20121, Italy
| | - Giovanni Callea
- Radiology Institute, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, Pavia 27100, Italy
| | - Silvia Panella
- Diagnostic and interventional radiology unit, ASST Santi Paolo e Carlo - San Paolo Hospital, Via Antonio di Rudiní 8, Milan 20142, Italy
| | - Maurizio Cariati
- Department of Advanced Diagnostic Technologies - Therapeutic, Diagnostic and Radiology Units, ASST Santi Paolo e Carlo - San Paolo Hospital, Via Antonio di Rudiní 8, Milan 20142, Italy
| | - Diletta Cozzi
- Department of Emergency Radiology, Careggi University Hospital, Largo Piero Palagi 1, Florence 50139, Italy
| | - Vittorio Miele
- Department of Emergency Radiology, Careggi University Hospital, Largo Piero Palagi 1, Florence 50139, Italy
| | - Elvira Stellato
- Postgraduation School in Radiodiagnostics, Universitá degli Studi di Milano, Via Festa del Perdono, 7, Milan 20122, Italy
| | - Gianpaolo Carrafiello
- Operative Unit of Radiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico of Milan, Via della Commenda, 10, Milan 20122, Italy; Department of Health Sciences, Univeristy of Milan, Via Festa del Perdono, 7, Milan 20122, Italy
| | - Giulia Castorani
- Diagnostic Imaging, Postgraduate Medical School, University of Foggia, Via Antonio Gramsci 89, Foggia 71122, Italy
| | - Annalisa Simeone
- Department of Diagnostic Imaging, IRCCS Ospedale Casa Sollievo della Sofferenza, Viale Cappuccini 1, San Giovanni Rotondo 71013, Italy
| | - Lorenzo Preda
- Radiology Institute, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, Pavia 27100, Italy; Radiology Unit, Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Corso Str. Nuova, 65, Pavia 27100 Italy
| | - Giulio Iannello
- Unit of Computer Systems and Bioinformatics, Department of Engineering, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 21, Rome 00128, Italy
| | - Alessio Del Bue
- Pattern Analysis and Computer Vision, Istituto Italiano di Tecnologia, Via Morego 30, Genoa 16163, Italy
| | - Fabio Tedoldi
- Bracco Imaging S.p.A., Via Caduti di Marcinelle 13, Milan 20134, Italy
| | - Marco Alí
- Department of Diagnostic Imaging and Stereotactic Radiosurgey, Centro Diagnostico Italiano S.p.A., Via S. Saint Bon 20, Milan 20147, Italy; Bracco Imaging S.p.A., Via Caduti di Marcinelle 13, Milan 20134, Italy
| | - Diego Sona
- Pattern Analysis and Computer Vision, Istituto Italiano di Tecnologia, Via Morego 30, Genoa 16163, Italy; Fondazione Bruno Kessler, Via Sommarive, 18, Trento 38123, Italy
| | - Sergio Papa
- Department of Diagnostic Imaging and Stereotactic Radiosurgey, Centro Diagnostico Italiano S.p.A., Via S. Saint Bon 20, Milan 20147, Italy
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Taibi C, Luzzitelli I, Visco Comandini U, Girardi E, Monacelli G, Rapisarda LM, Garbuglia AR, Minosse C, Guarrasi V, Vincenzi L, Iacomi F, D'Offizi G. Hepatitis C diagnosis and treatment in people who use drugs: mind the gap in the linkage to care. Eur Rev Med Pharmacol Sci 2021; 25:5913-5921. [PMID: 34661249 DOI: 10.26355/eurrev_202110_26867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The objective of this study is to identify a simplified rapid screening and linkage-to-care model for HCV among PWUD. PATIENTS AND METHODS The study stems from a collaborative project bringing together two local Italian Centers for Drug Addiction and the Hepatology-Infectious Diseases Department of Lazzaro Spallanzani. A research physician analyzed the available medical records seeking to identify HCV and HIV infected patients in care in the addiction centers. Between March 2018 and January 2020 subjects were selected from among a cohort of 720 PWUD in the two Centers' care. The study comprises three steps: first, screening for HCVAb; second, the linkage to care; third, clinical assessment to treatment. The research physician recruited patients for the first two steps directly in their local addiction center. The third step was conducted in the Spallanzani. The characteristics of those subjects who adhered to the three-step study program were then compared to those of the non-adhering PWUD. RESULTS 194 were known HCVAb positive patients. Of the 505 PWUD in the care of the two Centers eligible for screening, 364 were enrolled in the study. 144 resulted HCVAb positive. 269 were tested for HCVRNA. 101 underwent a full assessment. 96 patients started antiviral therapy with DAA. Patients who refused first step screening were older patients and mainly heroin users; in the second step, almost all the HIV/HCV co-infected patients agreed to a viremia test; in the third step all the HIV/HCV co-infected patients refused HCV treatment. CONCLUSIONS The study suggests an on-site specialist approach conducted directly in the addiction centers themselves starting from screening; it can bring the goal of HCV PWUD microelimination closer.
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Affiliation(s)
- C Taibi
- Hepatology and Infectious Diseases Department, National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Rome, Italy.
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Cipollari S, Guarrasi V, Pecoraro M, Bicchetti M, Messina E, Farina L, Paci P, Catalano C, Panebianco V. Convolutional Neural Networks for Automated Classification of Prostate Multiparametric Magnetic Resonance Imaging Based on Image Quality. J Magn Reson Imaging 2021; 55:480-490. [PMID: 34374181 PMCID: PMC9291235 DOI: 10.1002/jmri.27879] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/28/2021] [Accepted: 07/29/2021] [Indexed: 12/26/2022] Open
Abstract
Background Prostate magnetic resonance imaging (MRI) is technically demanding, requiring high image quality to reach its full diagnostic potential. An automated method to identify diagnostically inadequate images could help optimize image quality. Purpose To develop a convolutional neural networks (CNNs) based analysis pipeline for the classification of prostate MRI image quality. Study Type Retrospective. Subjects Three hundred sixteen prostate mpMRI scans and 312 men (median age 67). Field Strength/Sequence A 3 T; fast spin echo T2WI, echo planar imaging DWI, ADC, gradient‐echo dynamic contrast enhanced (DCE). Assessment MRI scans were reviewed by three genitourinary radiologists (V.P., M.D.M., S.C.) with 21, 12, and 5 years of experience, respectively. Sequences were labeled as high quality (Q1) or low quality (Q0) and used as the reference standard for all analyses. Statistical Tests Sequences were split into training, validation, and testing sets (869, 250, and 120 sequences, respectively). Inter‐reader agreement was assessed with the Fleiss kappa. Following preprocessing and data augmentation, 28 CNNs were trained on MRI slices for each sequence. Model performance was assessed on both a per‐slice and a per‐sequence basis. A pairwise t‐test was performed to compare performances of the classifiers. Results The number of sequences labeled as Q0 or Q1 was 38 vs. 278 for T2WI, 43 vs. 273 for DWI, 41 vs. 275 for ADC, and 38 vs. 253 for DCE. Inter‐reader agreement was almost perfect for T2WI and DCE and substantial for DWI and ADC. On the per‐slice analysis, accuracy was 89.95% ± 0.02% for T2WI, 79.83% ± 0.04% for DWI, 76.64% ± 0.04% for ADC, 96.62% ± 0.01% for DCE. On the per‐sequence analysis, accuracy was 100% ± 0.00% for T2WI, DWI, and DCE, and 92.31% ± 0.00% for ADC. The three best algorithms performed significantly better than the remaining ones on every sequence (P‐value < 0.05). Data Conclusion CNNs achieved high accuracy in classifying prostate MRI image quality on an individual‐slice basis and almost perfect accuracy when classifying the entire sequences. Evidence Level 4 Technical Efficacy Stage 1
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Affiliation(s)
- Stefano Cipollari
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University/Policlinico Umberto I, Rome, Italy
| | - Valerio Guarrasi
- Department of Computer, Control and Management Engineering, Sapienza University of Rome, Italy
| | - Martina Pecoraro
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University/Policlinico Umberto I, Rome, Italy
| | - Marco Bicchetti
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University/Policlinico Umberto I, Rome, Italy
| | - Emanuele Messina
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University/Policlinico Umberto I, Rome, Italy
| | - Lorenzo Farina
- Department of Computer, Control and Management Engineering, Sapienza University of Rome, Italy
| | - Paola Paci
- Department of Computer, Control and Management Engineering, Sapienza University of Rome, Italy
| | - Carlo Catalano
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University/Policlinico Umberto I, Rome, Italy
| | - Valeria Panebianco
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University/Policlinico Umberto I, Rome, Italy
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Del Chierico F, Manco M, Gardini S, Guarrasi V, Russo A, Bianchi M, Tortosa V, Quagliariello A, Shashaj B, Fintini D, Putignani L. Fecal microbiota signatures of insulin resistance, inflammation, and metabolic syndrome in youth with obesity: a pilot study. Acta Diabetol 2021; 58:1009-1022. [PMID: 33754165 DOI: 10.1007/s00592-020-01669-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 12/26/2020] [Indexed: 12/11/2022]
Abstract
AIMS To identify fecal microbiota profiles associated with metabolic abnormalities belonging to the metabolic syndrome (MS), high count of white blood cells (WBCs) and insulin resistance (IR). METHODS Sixty-eight young patients with obesity were stratified for percentile distribution of MS abnormalities. A MS risk score was defined as low, medium, and high MS risk. High WBCs were defined as a count ≥ 7.0 103/µL; severe obesity as body mass index Z-score ≥ 2 standard deviations; IR as homeostatic assessment model algorithm of IR (HOMA) ≥ 3.7. Stool samples were analyzed by 16S rRNA-based metagenomics. RESULTS We found reduced bacterial richness of fecal microbiota in patients with IR and high diastolic blood pressure (BP). Distinct microbial markers were associated to high BP (Clostridium and Clostridiaceae), low high-density lipoprotein cholesterol (Lachnospiraceae, Gemellaceae, Turicibacter), and high MS risk (Coriobacteriaceae), WBCs (Bacteroides caccae, Gemellaceae), severe obesity (Lachnospiraceae), and impaired glucose tolerance (Bacteroides ovatus and Enterobacteriaceae). Conversely, taxa such as Faecalibacterium prausnitzii, Parabacterodes, Bacteroides caccae, Oscillospira, Parabacterodes distasonis, Coprococcus, and Haemophilus parainfluenzae were associated to low MS risk score, triglycerides, fasting glucose and HOMA-IR, respectively. Supervised multilevel analysis grouped clearly "variable" patients based on the MS risk. CONCLUSIONS This was a proof-of-concept study opening the way at the identification of fecal microbiota signatures, precisely associated with cardiometabolic risk factors in young patients with obesity. These evidences led us to infer, while some gut bacteria have a detrimental role in exacerbating metabolic risk factors some others are beneficial ameliorating cardiovascular host health.
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Affiliation(s)
| | - Melania Manco
- Research Area for Multifactorial Diseases and Complex Phenotypes, Obesity and Diabetes, Bambino Gesù Children's Hospital, IRCCS, Via Ferdinando Baldelli 38, 00146, Rome, Italy.
| | | | - Valerio Guarrasi
- GenomeUp SRL, Rome, Italy
- Department of Computer, Control, and Management Engineering Antonio Ruberti, Sapienza University, Rome, Italy
| | - Alessandra Russo
- Unit of Parasitology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Marzia Bianchi
- Research Area for Multifactorial Diseases and Complex Phenotypes, Obesity and Diabetes, Bambino Gesù Children's Hospital, IRCCS, Via Ferdinando Baldelli 38, 00146, Rome, Italy
| | - Valentina Tortosa
- Unit of Human Microbiome, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | | | - Blegina Shashaj
- Research Area for Multifactorial Diseases and Complex Phenotypes, Obesity and Diabetes, Bambino Gesù Children's Hospital, IRCCS, Via Ferdinando Baldelli 38, 00146, Rome, Italy
| | - Danilo Fintini
- Endocrinology Unit, Bambino Gesù Children's Hospital, IRCCS, Palidoro, Rome, Italy
| | - Lorenza Putignani
- Unit of Parasitology and Unit of Human Microbiome, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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Fiscon G, Salvadore F, Guarrasi V, Garbuglia AR, Paci P. Assessing the impact of data-driven limitations on tracing and forecasting the outbreak dynamics of COVID-19. Comput Biol Med 2021; 135:104657. [PMID: 34303266 PMCID: PMC8285363 DOI: 10.1016/j.compbiomed.2021.104657] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/14/2021] [Accepted: 07/14/2021] [Indexed: 12/23/2022]
Abstract
The availability of the epidemiological data strongly affects the reliability of several mathematical models in tracing and forecasting COVID-19 pandemic, hampering a fair assessment of their relative performance. The marked difference between the lethality of the virus when comparing the first and second waves is an evident sign of the poor reliability of the data, also related to the variability over time in the number of performed swabs. During the early epidemic stage, swabs were made only to patients with severe symptoms taken to hospital or intensive care unit. Thus, asymptomatic people, not seeking medical assistance, remained undetected. Conversely, during the second wave of infection, total infectives included also a percentage of detected asymptomatic infectives, being tested due to close contacts with swab positives and thus registered by the health system. Here, we compared the outcomes of two SIR-type models (the standard SIR model and the A-SIR model that explicitly considers asymptomatic infectives) in reproducing the COVID-19 epidemic dynamic in Italy, Spain, Germany, and France during the first two infection waves, simulated separately. We found that the A-SIR model overcame the SIR model in simulating the first wave, whereas these discrepancies are reduced in simulating the second wave, when the accuracy of the epidemiological data is considerably higher. These results indicate that increasing the complexity of the model is useless and unnecessarily wasteful if not supported by an increased quality of the available data.
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Affiliation(s)
- Giulia Fiscon
- Institute for Systems Analysis and Computer Science "Antonio Ruberti", National Research Council, Rome, Italy; Fondazione per La Medicina Personalizzata, Via Goffredo Mameli, 3/1 Genova, Italy.
| | | | - Valerio Guarrasi
- Department of Computer, Control and Management Engineering "A. Ruberti" (DIAG), Sapienza University of Rome, Rome, Italy.
| | - Anna Rosa Garbuglia
- Laboratory of Virology, Lazzaro Spallanzani National Institute for Infectious Diseases, IRCCS, Rome, Italy.
| | - Paola Paci
- Institute for Systems Analysis and Computer Science "Antonio Ruberti", National Research Council, Rome, Italy; Department of Computer, Control and Management Engineering "A. Ruberti" (DIAG), Sapienza University of Rome, Rome, Italy.
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15
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Sias C, Guarrasi V, Minosse C, Lapa D, Nonno FD, Capobianchi MR, Garbuglia AR, Del Porto P, Paci P. Human Papillomavirus Infections in Cervical Samples From HIV-Positive Women: Evaluation of the Presence of the Nonavalent HPV Genotypes and Genetic Diversity. Front Microbiol 2020; 11:603657. [PMID: 33324386 PMCID: PMC7723855 DOI: 10.3389/fmicb.2020.603657] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 11/03/2020] [Indexed: 12/21/2022] Open
Abstract
Non-nonavalent vaccine (9v) Human papillomavirus (HPV) types have been shown to have high prevalence among HIV-positive women. Here, 1444 cervical samples were tested for HPV DNA positivity. Co-infections of the 9v HPV types with other HPV types were evaluated. The HPV81 L1 and L2 genes were used to investigate the genetic variability of antigenic epitopes. HPV-positive samples were genotyped using the HPVCLART2 assay. The L1 and L2 protein sequences were analyzed using a self-optimized prediction method to predict their secondary structure. Co-occurrence probabilities of the 9v HPV types were calculated. Non9v types represented 49% of the HPV infections; 31.2% of the non9v HPV types were among the low-grade squamous intraepithelial lesion samples, and 27.3% among the high-grade squamous intraepithelial lesion samples, and several genotypes were low risk. The co-occurrence of 9v HPV types with the other genotypes was not correlated with the filogenetic distance. HPV81 showed an amino-acid substitution within the BC loop (N75Q) and the FGb loop (T315N). In the L2 protein, all of the mutations were located outside antigenic sites. The weak cross-protection of the 9v types suggests the relevance of a sustainable and effective screening program, which should be implemented by HPV DNA testing that does not include only high-risk types.
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Affiliation(s)
- Catia Sias
- Laboratory of Virology, Lazzaro Spallanzani National Institute for Infectious Diseases, IRCCS, Rome, Italy
| | - Valerio Guarrasi
- Dipartimento di Ingegneria Informatica, Automatica e Gestionale “A. Ruberti”, Sapienza Università di Roma, Rome, Italy
| | - Claudia Minosse
- Laboratory of Virology, Lazzaro Spallanzani National Institute for Infectious Diseases, IRCCS, Rome, Italy
| | - Daniele Lapa
- Laboratory of Virology, Lazzaro Spallanzani National Institute for Infectious Diseases, IRCCS, Rome, Italy
| | - Franca Del Nonno
- Laboratory of Pathology, Lazzaro Spallanzani National Institute for Infectious Diseases, IRCCS, Rome, Italy
| | - Maria Rosaria Capobianchi
- Laboratory of Virology, Lazzaro Spallanzani National Institute for Infectious Diseases, IRCCS, Rome, Italy
| | - Anna Rosa Garbuglia
- Laboratory of Virology, Lazzaro Spallanzani National Institute for Infectious Diseases, IRCCS, Rome, Italy,*Correspondence: Anna Rosa Garbuglia,
| | - Paola Del Porto
- Department of Biology and Biotechnology “C. Darwin”, Sapienza University, Rome, Italy
| | - Paola Paci
- Dipartimento di Ingegneria Informatica, Automatica e Gestionale “A. Ruberti”, Sapienza Università di Roma, Rome, Italy
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Abstract
Objectives To determine whether patients with primary Sjögren's syndrome (SS), diagnosed according to San Diego criteria, had improvement in their laboratory or clinical features during treatment with hydroxychloroquine (6–7 mg/kg/day) for at least two years., Methods: The study population included 50 consecutive patients with primary SS who were diagnosed according to San Diego criteria, and in whom hydroxychloroquine was suggested as treatment. This group included 10 patients who were early dropouts (side effects or desire not to take antimalarial drugs) and 40 patients who received drugs for at least two years (range 24-48 months). In a subset of SS patients, values for ESR (westergren) and quantitative immunoglobulins were available for comparison. Improvement with therapy was defined as: (a) ≥20% improvement in variables of tear flow (Schirmer's test I) or corneal integrity (rose Bengal): (b) ≥20% salivary function (flow rate); and (c) improvement in at least two of the following measures: physicians assessment of global disease activity by ≥ 20%, patient assessment of improvement in pain or fatigue by ≥20%, and ESR improved by ≥20mm/ hr. Results In a retrospective study of SS patients who completed the trial, a significant improvement was noted in ocular symptoms (pain and dryness) in patients (55 and 57%) and improved corneal integrity (rose Bengal straining) in 53% of patients. The Schirmer's test was improved by ≥ 2 mm/5 minutes in 50% in patients. Improvement was noted in oral symptoms (pain and dryness) in patients (57 and 60%) and salivary flow rate was increased in 82% of patients. In a subset of SS patients evaluated, the ESR improved by ≥20mm/hr in 17/32 patients (53%) and quantitative IgG level by ≥20% in 8/13 patients (61%). Physician global assessment of overall patient status and patient assessment of overall status indicated improvement in over 62% of patients. Conclusion In a retrospective study of patients fulfilling San Diego Criteria for SS, we found: (a) sustained improvement of local symptoms (painful eyes, painful mouth) and improvement of systemic manifestations (arthralgias and myalgias) after treatment with hydroxychloroquine 6-7 mg/kg/day over mean three-year follow-up; (b) laboratory analysis showed a significant improvement in their ESR and their quantitative IgG levels; (c) no significant late toxicity was observed in this study cohort. A prospective study of hydroxychloroquine in patients fulfilling San Diego criteria for SS is indicated.
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Affiliation(s)
- Ri Fox
- Division of Rheumatology, Scripps Clinic and Research Foundation, La Jolla, California, USA
| | - R Dixon
- Division of Rheumatology, Scripps Clinic and Research Foundation, La Jolla, California, USA
| | - V Guarrasi
- Division of Rheumatology, Scripps Clinic and Research Foundation, La Jolla, California, USA
| | - S Krubel
- Division of Rheumatology, Scripps Clinic and Research Foundation, La Jolla, California, USA
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17
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Presti G, Guarrasi V, Gulotta E, Provenzano F, Provenzano A, Giuliano S, Monfreda M, Mangione MR, Passantino R, San Biagio PL, Costa MA, Giacomazza D. Bioactive compounds from extra virgin olive oils: Correlation between phenolic content and oxidative stress cell protection. Biophys Chem 2017; 230:109-116. [PMID: 28965785 DOI: 10.1016/j.bpc.2017.09.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 09/20/2017] [Accepted: 09/21/2017] [Indexed: 01/10/2023]
Abstract
When compared with other edible vegetable oils, the extra virgin olive oil (EVOO) exhibits excellent nutritional properties due to the presence of biophenolic compounds. Although they constitute only a very small amount of the unsaponifiable fraction of EVOO, biophenols strongly contribute to the sensorial properties of this precious food conferring it, for example, the bitter or pungent taste. Furthermore, it has been found that biophenols possess beneficial effects against many human pathologies such as oxidative stress, inflammation, cardiovascular diseases, cancer and aging-related illness. In the present work, the biophenolic content of 51 Italian and Spanish EVOOs was qualitatively and quantitatively identified and their antioxidant ability analyzed by oxygen radical absorbance capacity (ORAC) assay. Results indicated that the maximum relationship can be found if the ORAC value is correlated with the concentration of the large family composed by ligstroside and oleuropein derivatives together with their degradation products, hydroxytyrosol and tyrosol. Then, selected biophenolic extracts were tested in NIH-3T3 cell line to verify their ability in the recovery of the oxidative stress revealed by DCFH-DA assay. Results were linearly correlated with the concentration of ligstroside aglycone (aldehyde and hydroxyl form).
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Affiliation(s)
- G Presti
- Chemical Laboratory of Palermo, Italian Agency of Customs and Monopoles, via Crispi, 143, 90133 Palermo, Italy.
| | - V Guarrasi
- Istituto di Biofisica, Consiglio Nazionale delle Ricerche, Via Ugo La Malfa 153, 90146 Palermo, Italy.
| | - E Gulotta
- Chemical Laboratory of Palermo, Italian Agency of Customs and Monopoles, via Crispi, 143, 90133 Palermo, Italy.
| | - F Provenzano
- Istituto di Biofisica, Consiglio Nazionale delle Ricerche, Via Ugo La Malfa 153, 90146 Palermo, Italy.
| | - A Provenzano
- Istituto di Biofisica, Consiglio Nazionale delle Ricerche, Via Ugo La Malfa 153, 90146 Palermo, Italy.
| | - S Giuliano
- Chemical Laboratory of Palermo, Italian Agency of Customs and Monopoles, via Crispi, 143, 90133 Palermo, Italy.
| | - M Monfreda
- Central Directorate for Product Analysis and Chemical Laboratories, Italian Agency of Customs and Monopoles, via M. Carucci 71, 00143 Rome, Italy.
| | - M R Mangione
- Istituto di Biofisica, Consiglio Nazionale delle Ricerche, Via Ugo La Malfa 153, 90146 Palermo, Italy.
| | - R Passantino
- Istituto di Biofisica, Consiglio Nazionale delle Ricerche, Via Ugo La Malfa 153, 90146 Palermo, Italy.
| | - P L San Biagio
- Istituto di Biofisica, Consiglio Nazionale delle Ricerche, Via Ugo La Malfa 153, 90146 Palermo, Italy.
| | - M A Costa
- Istituto di Biofisica, Consiglio Nazionale delle Ricerche, Via Ugo La Malfa 153, 90146 Palermo, Italy.
| | - D Giacomazza
- Istituto di Biofisica, Consiglio Nazionale delle Ricerche, Via Ugo La Malfa 153, 90146 Palermo, Italy.
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18
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Settanni L, Randazzo W, Palazzolo E, Moschetti M, Aleo A, Guarrasi V, Mammina C, San Biagio P, Marra F, Moschetti G, Germanà M. Seasonal variations of antimicrobial activity and chemical composition of essential oils extracted from threeCitrus limonL. Burm. cultivars. Nat Prod Res 2014; 28:383-91. [DOI: 10.1080/14786419.2013.871544] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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19
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Guarrasi V, Mangione MR, Sanfratello V, Martorana V, Bulone D. Quantification of Underivatized Fatty Acids From Vegetable Oils by HPLC with UV Detection. J Chromatogr Sci 2010; 48:663-8. [DOI: 10.1093/chromsci/48.8.663] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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20
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Fox RI, Dixon R, Guarrasi V, Krubel S. Treatment of primary Sjögren's syndrome with hydroxychloroquine: a retrospective, open-label study. Lupus 1996; 5 Suppl 1:S31-6. [PMID: 8803908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To determine whether patients with primary Sjögren's syndrome (SS), diagnosed according to San Diego criteria, had improvement in their laboratory or clinical features during treatment with hydroxychloroquine (6-7 mg/kg/day) for at least two years. METHODS The study population included 50 consecutive patients with primary SS who were diagnosed according to San Diego criteria, and in whom hydroxychloroquine was suggested as treatment. This group included 10 patients who were early dropouts (side effects or desire not to take antimalarial drugs) and 40 patients who received drugs for at least two years (range 24-48 months). In a subset of SS patients, values for ESR (westergren) and quantitative immunoglobulins were available for comparison. Improvement with therapy was defined as: (a) > or = 20% improvement in variables of tear flow (Schirmer's test I) or corneal integrity (rose Bengal): (b) > or = 20% salivary function (flow rate); and (c) improvement in at least two of the following measures: physicians assessment of global disease activity by > or = 20%, patient assessment of improvement in pain or fatigue by > or = 20%, and ESR improved by > or = 20 mm/hr. RESULTS In a retrospective study of SS patients who completed the trial, a significant improvement was noted in ocular symptoms (pain and dryness) in patients (55 and 57%) and improved corneal integrity (rose Bengal straining) in 53% of patients. The Schirmer's test was improved by > or = 2 mm/5 minutes in 50% in patients. Improvement was noted in oral symptoms (pain and dryness) in patients (57 and 60%) and salivary flow rate was increased in 82% of patients. In a subset of SS patients evaluated, the ESR improved by > or = 20 mm/hr in 17/32 patients (53%) and quantitative IgG level by > or = 20% in 8/13 patients (61%). Physician global assessment of overall patient status and patient assessment of overall status indicated improvement in over 62% of patients. CONCLUSION In a retrospective study of patients fulfilling San Diego Criteria for SS, we found: (a) sustained improvement of local symptoms (painful eyes, painful mouth) and improvement of systemic manifestations (arthralgias and myalgias) after treatment with hydroxychloroquine 6-7 mg/kg/day over mean three-year follow-up; (b) laboratory analysis showed a significant improvement in their ESR and their quantitative IgG levels; (c) no significant late toxicity was observed in this study cohort. A prospective study of hydroxychloroquine in patients fulfilling San Diego criteria for SS is indicated.
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Affiliation(s)
- R I Fox
- Division of Rheumatology, Scripps Clinic and Research Foundation, La Jolla, CA 92037, USA
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